Community and hospital stroke patients: long-term rehabilitation

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Abstract
This article compares the outcomes and services provided for stroke patients who had not been admitted to hospital with those provided to patients who had been admitted to hospital for less than 1 month. Patients were assessed 1 month and 1 year after stroke on measures of impairment and disability. The rehabilitation they had received was recorded. There were 243 stroke patients notified by GPs of whom 124 had not been admitted to hospital. Of these, 93 were assessed at 1 month and 76 at 1 year after stroke. There were 97 patients admitted to hospital, 86 were assessed at 1 month and 65 1 year after stroke. Comparison between community and hospital patients showed no significant difference on the Barthel Index, but a significant difference on the Extended Activities of Daily Living scale at 1 month and 1 year after stroke. There were few significant differences in motor function, cognitive impairment or mood, but community patients showed significantly less handicap. The provision of rehabilitation services was low, but those admitted to hospital received significantly more rehabilitation, despite few differences in their abilities. Admission to hospital is associated with better provision of rehabilitation services regardless of patients' disabilities.

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